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Scoliosis

What is Scoliosis?

Scoliosis is a type of spinal deformity that occurs when the spine develops an abnormal sideways curvature. When viewed from the front on an imaging device, a healthy spine will appear to be a straight, vertical line. In an individual with scoliosis, the spine adopts a series of curves and twists that often resembles an S in shape.

Those who suffer from scoliosis will typically display a 15-degree to 50-degree bend in their spine. Some people have only one bend, while others have multiple bends at different junctures in their spine. Depending upon the severity of the bend(s), a person’s pelvis may become tilted as well. In most cases, scoliosis is a progressive condition and becomes worse over a period of time.

Although scoliosis can result from congenital defects in the spine, most people who suffer from scoliosis develop the condition between the ages of 10 to 14. It is important to understand, however, that there is more than one type of scoliosis. The four primary types of scoliosis include:

Congenital: This type of scoliosis occurs when an individual is born with structural deformities in the spine.

Neuromuscular/Myopathic: This form of scoliosis develops in children who suffer from one or more neuromuscular disorders, such as cerebral palsy or muscular dystrophy.

Degenerative: Degenerative Scoliosis typically develops in individuals who are older than 65, as the facet joints and intervertebral discs that enable fluid motion of the spine begin to break down with age. If one segment of the spine is affected more profoundly than the rest of the spine, abnormal curvature may develop at the point of weakness.

Idiopathic: By far the most common type of scoliosis, idiopathic scoliosis refers to a form of scoliosis that develops from an unknown origin. It is speculated that the vast majority of idiopathic scoliosis cases result from genetic influences.

Concerned that you (or your child) might have scoliosis? Since scoliosis most commonly develops during adolescence, many individuals are unaware that they have the condition until they experience pain in adulthood. Don’t delay your diagnosis any further! When it comes to scoliosis, the earliest treatments are the most effective at preventing your condition from worsening. Dr. Frazier of NYC Spine has over 20 years of experience in resolving spinal deformities that cause scoliosis or kyphosis.

What are the Symptoms of Scoliosis?

A person who suffers from scoliosis may display obvious physical characteristics of the condition. However, for many individuals with mild to moderate scoliotic curvatures, pain may be the only indicator that a structural problem is present.

Generally, a physician can complete a thorough physical exam followed by x-rays to determine if scoliosis is present. If you believe that you (or your child) might be suffering from scoliosis, you can ask the following questions: Are the eyes level or do you see a tilted eye line? When standing straight up, do the shoulders hang evenly or is one of them higher than the other? Is the pelvis even, or does one hip sit higher than the other? Is the ear line level? Any unevenness can be a sign that scoliosis is present. Symptoms of scoliosis typically include:

Visible Signs of Spinal Deformity: If your scoliosis is severe (or even moderate) you may notice visible asymmetries in the spine, trunk, or limbs. These physical indicators may include:

Abnormal curvature of the neck

One hip, shoulder, or collarbone that is higher than the other

An asymmetrical rib cage

Clothes that hang improperly off of the body

Differences in leg length

Back Pain: Radiating or chronic pain in the cervical (neck), thoracic (mid-back), or lumbar (spine) where the exaggerated curvature of your spine compresses against nerve roots, signaling pain.

Neurological Symptoms: Numbness, tingling, or weakness in the limbs that stems from nerve impingement in the spine.

Reduced Lung or Cardiac Capacity: Severe scoliosis can interfere with the functioning or your heart and lungs, which also leads to chronic fatigue.

Scoliosis is speculated to be a hereditary condition, meaning that it runs in families. And while girls tend to suffer more from this condition than boys, it is not uncommon for males to develop it as well. When going to regular checkups to the doctor, it is always important to ask for a scoliosis check, especially if it runs in your family. Thanks to advances in the medical field, there is now a saliva test that can be performed known as Scolioscore that helps measure the probability of a child developing this condition.

It is highly recommended that if you believe you or your child is suffering from scoliosis that you do not wait to have the condition diagnosed and treated. The sooner you can receive a diagnosis for it, the sooner a treatment plan can be created. And the sooner treatment starts, the more likely the treatment is to be effective and to help your condition from worsening. Contact Dr. Frazier with NYC Spine today to learn more about the diagnosis and treatment of scoliosis.

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What are the Treatments for Scoliosis?

For curves in the spine that do not measure more than 24 degrees, some physicians will recommend no treatment — just regular observations and checkups to make certain that your condition is stable. For bends in the spine that measure anywhere from 24 to 39 degrees, a spinal brace may be recommended. Some doctors will not support the wearing of a spinal brace. Why is this? Well, it is mostly because wearing this type of brace does not actually stop or slow down the progression of the condition. Also, some studies show that wearing a brace actually decreases lung function, which can ultimately lead to respiratory distress; this can lead to sleep problems, headaches, and more.

If you have a bend measuring 40 degrees or more, then a corrective surgery will be recommended. There are many types of surgical approaches for scoliosis, with the most common being:

Minimally Invasive Anterior Lumbar Interbody Fusion: An ALIF is a surgical procedure that is used to correct scoliosis by inserting a bone graft and/or mechanical hardware that fuses sections of the spine together. Minimally invasive spinal fusion restores both structure and stability to your spine, permanently correcting your spinal deformity. Because this approach accesses your spine from the front, the strong muscles and supportive tissues of your back are undisturbed. This ultimately leads to reduced recovery times from surgery.

Minimally Invasive Posterior Lumbar Interbody Fusion: If your scoliosis involves more than one curve, your doctor may recommend a PLIF. Like an ALIF, the PLIF uses a bone graft and/or rods and screws to reinforce your spine and correct spinal deformity. However, unlike an ALIF, a PLIF accesses your spine from the posterior (or back) side. This type of surgical intervention is most common for scoliosis correction, as individuals with pronounced back pain from scoliosis usually have more than one section of abnormal spine curvature.

It should be noted, however, that even if you have a bend that does not measure more than 24 degrees, you can always take precautionary steps to help ensure the curve does not worsen; this is why it is so important to speak with a scoliosis specialist to see which preventative treatment options may work best for you. Contact Dr. Frazier with NYC Spine today to learn more about your treatment options for pain management and surgical intervention.

Dr. Frazier is a Harvard-trained, board certified orthopedic spine surgeon. He’s held an academic appointment at Columbia University College of Physicians and Surgeons and New York’s SUNY Downstate. Dr. Frazier is also a respected lecturer, accomplished researcher, published author on spine disorders and treatment, and a consultant for several international spine companies.

After completing his undergraduate education at Brown University, Dr. Frazier attended Harvard Medical School, where he graduated cum laude. He completed a Harvard internship based at the New England Deaconess Hospital in Boston, MA, followed by a Harvard combined residency before becoming chief resident at Massachusetts General Hospital.